Jack's Trouble:
Hi, my name is Jack and I am 17 years old. I go to a normal high school and have a normal social life. However, I have trouble sleeping at night. At night, when it is time for many people to go to bed, and start to feel tired, I don't feel sleepy or tired at all. Even when I try to sleep, I just can't fall asleep. Even when I close my eyes, my brain is still awake. When very rarely I fall asleep, I wake up again after about 2 or 3 hours. I never get enough sleep even though I want to. Then, when it's morning, I start to get tired, but I can't sleep because I need to get ready for school. As a result, I'm always tired and inactive at school and I'm unable to perform my academic skills at the best of my ability. After school, I go to bed right after I get home for about 5 to 6 hours. I'm too tired to go through the rest of the day without a nap. I am like an owl; sleeping at day and being active at night.




Diagnosis

It appears that Jack has symptoms of depression, since he is frustrated by his inability to sleep. Although this may be simply a result of physical health issue, depression often accompanies the lack of a proper sleeping pattern. Insomnia is often a precursor to depression, and the fact that Jack cannot perform his duties to his fullest ability causes some concern about this pattern growing worse. According to a paper presented at the Annual Meeting of the Associated Professional Sleep Societies (APSS), "patients experiencing major depression found that those suffering from insomnia were over 10 times more likely still to be depressed after 6 months than those without insomnia." This speaks to the fact that abnormal sleeping patterns are correlated to depression, and that it may become one of the contributing factors to developing depression. In short, Jack is not depressed, but is merely suffering from insomnia.

Treatment
At the moment, I would not yet recommend treatment for depression. Instead, I would recommend treatment specifically for insomnia, as a way of prevention. Insomnia treatment involves both non-medical and medical methods. I recommend counseling, since insomnia often has an underlying problem. Addressing this problem may significantly improve the pattern of sleep. Jack would also need to adjust his life-style in a way to accommodate his sleeping--controlling stimulants (such as caffeine and TV) before sleep, relaxation, and exercising. As for medication, I would recommend Melatonin, since it can aid him in bringing back his circadian rhythm.

References

"Insomnia Causes, Symptoms, diagnosis, Treatment and Prevention by eMedicineHealth.com." eMedicinehealth. N.p., n.d. Web. 8 Jan. 2010. <www.emedicinehealth.com/insomnia/page9_em.htm>.

Mulhauser, Greg . " Sleep and the Treatment of Depression." Online Therapy, Counselling & Mental Health Resources. N.p., 22 June 2005. Web. 8 Jan. 2010. <http://counsellingresource.com/features/2005/06/22/sleep-depression/>.